Heritability of dehydroepiandrosterone sulfate in women with polycystic ovary syndrome and their sisters

ObjectiveTo test the hypothesis that adrenal androgen (AA) secretion is an inherited trait in PCOS and that serum DHEAS concentrations, as a marker of AA secretion, will be correlated between women with PCOS and their sisters.DesignProspective case-control.SettingTertiary care center.Patient(s)Sixty-two PCOS probands and 69 sisters.Intervention(s)None.Main Outcome Measure(s)The DHEAS concentrations and clinical phenotypes were obtained. Familial correlation between sisters was estimated. A variance components model was used to estimate the heritability (h2) of the DHEAS levels. Body mass index (BMI)–adjusted DHEAS levels were used in all of the analyses.Result(s)There was no difference in age between the proband and sister groups (28.7 ± 8.1 years vs. 28.0 ± 8.8 years, P=.65), and probands had higher BMI values (33.4 ± 7.6 kg/m2 vs. 27.9 ± 7.0 kg/m2, P<.001). Sixteen of the 69 (23.2%) sisters were affected by PCOS. The sister-sister correlation of DHEAS level was 0.28 ± 0.12 for the whole group (P<.05), and this correlation was higher, at 0.38 ± 0.14 (P≤.05), after excluding 31% of the affected sisters and 34% of the unaffected sisters who received hormonal therapy at or within 3 months of the time of the study. The h2 estimates of DHEAS were 0.43 (P=.037) and 0.44 (P=.062) when all sisters and only untreated sisters, respectively, were included in the analysis.Conclusion(s)The correlation of serum DHEAS levels between PCOS probands and their sisters suggests a familial component in the regulation of DHEAS levels and possibly AA production in PCOS. The h2 estimates of 0.43–0.44 for BMI-adjusted DHEAS suggest that genetic factors account for between 40% and 50% of the overall variation in DHEAS levels in these women. Our results support the hypothesis that circulating AA levels represent an inherited trait in PCOS.